Hwang Won Joo, Lee Do Heon, Choi Won, Hwang Jae Ha, Kim Kwang Seog, Lee Sam Yong
Department of Plastic and Reconstructive Surgery, Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea.
J Craniofac Surg. 2017 Oct;28(7):1664-1669. doi: 10.1097/SCS.0000000000003730.
Hinge-shaped fractures are common type of orbital floor blowout fractures, for which reduction and internal fixation is ideal. Nonetheless, orbital floor reconstruction using alloplastic materials without reducing the number of bone fragments is the most frequently used procedure. Therefore, this study analyzed and compared the outcomes between open reduction and internal fixation using absorbable mesh plates and screws, and orbital floor reconstruction, by measuring the orbital volume before and after surgery.
Among patients with orbital floor blowout fractures, this study was conducted on 28 patients who underwent open reduction and internal fixation, and 27 patients who underwent orbital floor reconstruction from December 2008 to September 2015. The mechanism of injury, ophthalmic symptoms before and after surgery, and the degree of enophthalmos were examined; subsequently, the volumes of the affected and unaffected sides were measured before and after surgery based on computed tomography images. This study compared the degree of recovery in the correction rate of the orbital volume, ophthalmic symptoms, and enophthalmos between the 2 groups.
The patients who underwent open reduction and internal fixation, and the patients who underwent orbital floor reconstruction showed average correction rates of 100.36% and 105.24%, respectively. Open reduction and internal fixation showed statistically, significantly superior treatment outcomes compared with orbital floor reconstruction. The ophthalmic symptoms and incidence of enophthalmos completely resolved in both groups.
For orbital floor blowout fractures, open reduction and internal fixation using absorbable mesh plates and screws was a feasible alternative to orbital floor reconstruction.
铰链形骨折是眶底爆裂骨折的常见类型,对此类骨折进行复位和内固定是理想的治疗方法。尽管如此,不减少骨碎片数量而使用异体材料进行眶底重建是最常用的手术方法。因此,本研究通过测量手术前后的眼眶容积,分析并比较了使用可吸收网片和螺钉进行切开复位内固定与眶底重建的治疗效果。
本研究选取了2008年12月至2015年9月期间接受切开复位内固定的28例眶底爆裂骨折患者和接受眶底重建的27例患者。检查损伤机制、手术前后的眼部症状以及眼球内陷程度;随后,根据计算机断层扫描图像测量手术前后患侧和健侧的眼眶容积。本研究比较了两组在眼眶容积矫正率、眼部症状和眼球内陷恢复程度方面的差异。
接受切开复位内固定的患者和接受眶底重建的患者的平均矫正率分别为100.36%和105.24%。与眶底重建相比,切开复位内固定在统计学上显示出显著更优的治疗效果。两组的眼部症状和眼球内陷发生率均完全缓解。
对于眶底爆裂骨折,使用可吸收网片和螺钉进行切开复位内固定是眶底重建的一种可行替代方法。